Title Investigation of air dispersal during a rhinovirus outbreak in a pediatric intensive care unit.
Author Wong, Shuk-Ching; Yip, Cyril Chik-Yan; Chen, Jonathan Hon-Kwan; Yuen, Lithia Lai-Ha; AuYeung, Christine Ho-Yan; Chan, Wan-Mui; Chu, Allen Wing-Ho; Leung, Rhoda Cheuk-Ying; Ip, Jonathan Daniel; So, Simon Yung-Chun; Yuen, Kwok-Yung; To, Kelvin Kai-Wang; Cheng, Vincent Chi-Chung
Journal Am J Infect Control Publication Year/Month 2023-Nov
PMID 37972820 PMCID -N/A-
Affiliation + expend 1.Infection Control Team, Queen Mary Hospital, Hong Kong West Cluster, Hong Kong Special Administrative Region, China.

BACKGROUND: While airborne transmission of rhinovirus is recognized in indoor settings, its role in hospital transmission remains unclear. METHODS: We investigated an outbreak of rhinovirus in a pediatric intensive care unit (PICU) to assess air dispersal. We collected clinical, environmental, and air samples, and staff\'s surgical masks for viral load and phylogenetic analysis. Hand hygiene compliance and the number of air-changes-per-hour (ACH) in the PICU were measured. A case-control analysis was performed to identify nosocomial rhinovirus risk factors. RESULTS: Between March 31, 2023, and April 2, 2023, three patients acquired rhinovirus in a cubicle (ACH: 14) of 12-bed PICU. A portable air cleaning unit was placed promptly. Air sample (72,000L in 6 hours) from the cohort area, and outer surfaces of staff\'s masks (n=8), were rhinovirus RNA-negative. Hand hygiene compliance showed no significant differences (31/34, 91.2% vs 33/37, 89.2%, p=1) before and during outbreak. Only one environmental sample (3.8%) was positive (1.86x10(3) copies/mL). Case-control and next-generation sequencing analysis implicated an infected staff member as the source. CONCLUSION: Our findings suggest that air dispersal of rhinovirus was not documented in the well-ventilated PICU during the outbreak. Further research is needed to better understand the dynamics of rhinovirus transmission in healthcare settings.

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